Acta Endicronologica
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January - March 2005, Volume 1, Issue 1
General Endocrinology

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Acta Endocrinologica (Buc)


Galoiu SA, Kertesz G, Somma C, Coculescu M, Brue T

Clinical expression of big-big prolactin and influence of macroprolactinemia upon immunodiagnostic tests

Acta Endo (Buc) 2005, 1 (1): 31-41
doi: 10.4183/aeb.2005.31

In some humans, the big and big-big prolactin variants represent the majority of circulating prolactin, considered to be without biological activity. Aims: to establish the clinical expression of macroprolactinemia and the interference with immunodiagnostic tests\r\nin a randomized group of 84 consecutive patients with hyperprolactinemia. IRMA and electrochemiluminescence (Elecsys) were used for PRL assay; gel filtration chromatography (GFC) and protein A precipitation test were used to reveal macroprolactinemia. Results: Macroprolactinemia was found in 16 out of 84 patients (group A), 62 patients had hyperprolactinemia of other causes (group B) and 6 had normal PRL levels and normal GFC (group C). Of 16 patients with macroprolactinemia, 6 showed normal PRL with IRMA and hyperprolactinemia with Elecsys. The difference between the two methods used (&#8710; = PRL determined by Elecsys, -PRL determined by IRMA) correlated with big big PRL level determined by GFC with Elecsys in all patients. The strongest correlation was found in patients with macroprolactinemia (group A, r=0.82, p<0.01) as compared with group B, without macroprolactinemia (r=0.39, p<0.01). Menstrual disorders were expressed, but less frequent in group A versus B (3/15 vs. 28/56, p=0.04), and the appearance of galactorrhea and infertility were not statistically different. Conclusions: In these patients, macroprolactinemia had clinical expression, but weaker than in true hyperprolactinemic patients. It determines high apparent variability of serum PRL level in current commercial assays.

Keywords: macroprolactinemia, big-big prolactin, immunoassay, hyperprolactinemia

Correspondence: Simona Galoiu, Department of Endocrinology, ?Carol Davila? University of Medicine and Pharmacy, Bucharest, Romania, e-mail: simonagaloiu@yahoo.com

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ISSN (print): 1841 - 0987     ISSN (online): 1843 - 066X  
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